Obstetric Comorbidity Index in Postpartum Hemorrhage

Mahidol University

Status

Completed

Conditions

Cesarean Section Complications

Morbidity;Perinatal

Postpartum Hemorrhage

Treatments

Other: Obstetric comorbidity index

Study type

Observational

Funder types

Other

Identifiers

NCT06431204

351/2567(IRB2)

Si 359/2024 (Other Identifier)

Details and patient eligibility

About

The objective of this study is to examine the predictive capability of the Obstetric comorbidity index in the identification of severe maternal morbidity associated with postpartum hemorrhage in patients undergoing cesarean delivery.

Full description

The prospectively predictive maternal morbidity is imperative to enhance maternal outcomes. There has been development of the obstetric comorbidity index (OBCMI) by Bateman et al. in 2013 and performed with superior performance characteristics relative to general comorbidity measures in an obstetric population. The score has been a growing recognition of the necessity for specialized risk assessment tools tailored specifically to obstetric populations that differ from other populations. For instance, both the Charlson/Romano comorbidity index or the Elixhauser comorbidity score and their adaptations are deficient in accounting for obstetric conditions, thereby limiting their ability to predict obstetric morbidity or mortality.

The Obstetric Comorbidity Index has undergone thorough examination and validation across multiple nations. These findings collectively demonstrate the index's capacity for moderate to high predictive accuracy in anticipating maternal morbidities, accompanied by a commendable discriminative performance.

However, within the context of Thailand, investigations concerning the Obstetric Comorbidity Index and its association with perioperative complications or morbidities in postpartum hemorrhage patients undergoing cesarean delivery remain unexplored. Therefore, this study aims to elucidate the correlation between the Obstetric Comorbidity Index and severe maternal morbidity, while also scrutinizing the prevalence of comorbidities during the perioperative period among patients undergoing cesarean delivery at the largest University hospital, in THAILAND. Predicting the rate of maternal morbidity would be advantageous for facilitating preparation and augmenting awareness of complications during the perioperative period.

Enrollment

583 patients

Sex

Female

Volunteers

No Healthy Volunteers

Inclusion criteria

The patients underwent cesarean delivery with the diagnosis of postpartum hemorrhage (ICD-10 coding O72.1)

Exclusion criteria

Cesarean delivery at less than 24 weeks of gestation
A patient chart that does not contain primary outcome data eg. absence of anesthetic record
Blood loss less than 1,000 ml in the first 24 hours postpartum

Trial design

583 participants in 2 patient groups

Patients with postpartum hemorrhage with severe maternal morbidity

Description:

Patients with either one of severe maternal morbidity (severe hemorrhage, hypertension/neurologic, renal, sepsis, pulmonary, cardiac, intensive care unit, and anesthesia complications)

Treatment:

Other: Obstetric comorbidity index

Patients with postpartum hemorrhage without severe maternal morbidity

Description:

Patients without the severe maternal morbidity conditions

Treatment:

Other: Obstetric comorbidity index